Abstract

The mechanisms leading to latency and reactivation of human tuberculosis are still unclear, mainly due to the lack of standardized animal models for latent mycobacterial infection. In this longitudinal study of the progression of a mycobacterial disease in adult zebrafish, we show that an experimental intraperitoneal infection with a low dose (∼35 bacteria) of Mycobacterium marinum, results in the development of a latent disease in most individuals. The infection is characterized by limited mortality (25%), stable bacterial loads 4 weeks following infection and constant numbers of highly organized granulomas in few target organs. The majority of bacteria are dormant during a latent mycobacterial infection in zebrafish, and can be activated by resuscitation promoting factor ex vivo. In 5–10% of tuberculosis cases in humans, the disease is reactivated usually as a consequence of immune suppression. In our model, we are able to show that reactivation can be efficiently induced in infected zebrafish by γ-irradiation that transiently depletes granulo/monocyte and lymphocyte pools, as determined by flow cytometry. This immunosuppression causes reactivation of the dormant mycobacterial population and a rapid outgrowth of bacteria, leading to 88% mortality in four weeks. In this study, the adult zebrafish presents itself as a unique non-mammalian vertebrate model for studying the development of latency, regulation of mycobacterial dormancy, as well as reactivation of latent or subclinical tuberculosis. The possibilities for screening for host and pathogen factors affecting the disease progression, and identifying novel therapeutic agents and vaccine targets make this established model especially attractive.

Highlights

  • Tuberculosis (TB) is caused by Mycobacterium tuberculosis, a highly specialized pathogen capable of evading the immune defense by various strategies

  • Mycobacteria can persist in their host without causing symptoms – a state referred to as latency or subclinical infection

  • Using Mycobacterium marinum, a natural fish pathogen and a close relative of M. tuberculosis, we were able to induce a disease in adult zebrafish closely mimicking the human latent disease

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Summary

Introduction

Tuberculosis (TB) is caused by Mycobacterium tuberculosis, a highly specialized pathogen capable of evading the immune defense by various strategies. The success of the pathogen and the shortcomings of current medical interventions are reflected by the high prevalence of M. tuberculosis infection; one third of the world’s population has been estimated to carry the pathogen and to have a latent, subclinical infection [1], which can be diagnosed using immunological sensitization to M. tuberculosis antigens [2]. This asymptomatic infection is thought to consist of a variety of disease states that differ in bacterial phenotypes and burdens.

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